Abstract
The present studies evaluated whether experiencing depressive cognition as visual (i.e., in the form of visual mental imagery) or verbal (i.e., in the form of verbal thought) was differentially associated with the strength of the rumination–depression relationship. Visual mental imagery is consistently found to be more emotionally arousing than verbal thought. This may especially be the case when individuals dwell on their visual or verbal depressive cognition in the form of depressive rumination. In Study 1, 41.2% of participants reported a visual depressive cognitive style and 57.1% reported a verbal depressive cognitive style. For both males and females, rumination was associated with similarly severe depressive symptoms when individuals reported experiencing visual depressive cognitions compared with verbal depressive cognitions. Study 2 replicated and extended Study 1, taking into account that some individuals may experience depressive cognition both visually and verbally. 23.8% of participants reported a visual depressive cognitive style, 38.9% a verbal depressive cognitive style, and 37.3% a both visual and verbal depressive cognitive style. Rumination was significantly associated with depressive symptom severity for all depressive cognitive styles (visual, verbal, both), though depressive cognitive style significantly moderated the relationship between rumination and depressive symptom severity such that there was a stronger relationship for individuals who had a visual depressive cognitive style than a verbal depressive cognitive style, especially for females. Findings suggest that dwelling on depressed affect (i.e., rumination) may be more strongly related to depressive symptom severity when individuals tend to experience depressive cognitions as visual. Examination of depressive cognition as both visual and verbal is necessary to fully understand how individuals think about their depressed affect and may eventually inform tailoring of interventions based on visual/verbal styles of depressive cognition.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
Given evidence that there may be brooding and reflection subtypes of rumination (e.g., Burwell and Shirk 2007), all analyses were re-run using only the brooding or reflection subscales of the RRS. As patterns of findings using the rumination total score, brooding subscale score, and/or reflection subscale score were identical, only the results for the rumination total score are presented.
Given that Little’s test was marginally significant, follow-up analyses were conducted to compare participants who were missing at least one item with participants with complete data. On the RRS, participants who had missing data did not differ from participants who did not have missing data, t(124) = 0.46, p = 0.96; d = 0.26. On the CES-D, participants who had missing data also did not differ from participants who did not have missing data, t(125) = 0.33, p = 0.74; d = 0.13.
As in Study 1, all analyses were repeated with the brooding and reflection subscales of the RRS. All patterns of findings were analogous using the rumination total score, brooding subscale score, and reflection subscale score; thus, results using the rumination total score are presented.
References
Anderson, R. J., & Evans, G. L. (2015). Mental time travel in dysphoria: Differences in the content and subjective experience of past and future episodes. Consciousness and Cognition: An International Journal, 37, 237–248. https://doi.org/10.1016/j.concog.2014.05.006.
Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: Meridian.
Behar, E., Zuellig, A. R., & Borkovec, T. D. (2005). Thought and imaginal activity during worry and trauma recall. Behavior Therapy, 36, 157–168. https://doi.org/10.1016/S0005-7894(05)80064-4.
Borkovec, T. D. (1994). The nature, functions, and origins of worry. Oxford: Wiley
Borkovec, T. D., Alcaine, O., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder. In Generalized anxiety disorder: Advances in research and practice.
Borkovec, T. D., & Inz, J. (1990). The nature of worry in generalized anxiety disorder: A predominance of thought activity. Behaviour Research and Therapy, 28, 153–158. https://doi.org/10.1016/0005-7967(90)90027-G.
Borkovec, T. D., Ray, W. J., & Stöber, J. (1998). Worry: A cognitive phenomenon intimately linked to affective, physiological, and interpersonal behavioral processes. Cognitive Therapy and Research, 22, 561–576. https://doi.org/10.1023/A:1018790003416.
Burwell, R. A., & Shirk, S. R. (2007). Subtypes of rumination in adolescence: associations between brooding, reflection, depressive symptoms, and coping. Journal of Clinical Child and Adolescent Psychology, 36, 56–65. https://doi.org/10.1207/s15374424jccp3601_6.
Butler, L. D., & Nolen-Hoeksema, S. (1994). Gender differences in responses to depressed mood in a college sample. Sex Roles, 30, 331–346.
Ehring, T., & Watkins, E. R. (2008). Repetitive negative thinking as a transdiagnostic process. International Journal of Cognitive Therapy, 1, 192–205. https://doi.org/10.1680/ijct.2008.1.3.192.
Freeston, M. H., Ladouceur, R., Thibodeau, N., & Gagnon, F. (1992). Cognitive intrusions in a non-clinical population: II. Associations with depressive, anxious, and compulsive symptoms. Behaviour Research and Therapy, 30, 263–271. https://doi.org/10.1016/0005-7967(92)90072-O.
Fresco, D. M., Frankel, A. N., Mennin, D. S., Turk, C. L., & Heimberg, R. G. (2002). Distinct and overlapping features of rumination and worry: The relationship of cognitive production to negative affective states. Cognitive Therapy and Research, 26, 179–188. https://doi.org/10.1023/A:1014517718949.
Ganis, G., Thompson, W. L., & Kosslyn, S. M. (2004). Brain areas underlying visual mental imagery and visual perception: An fMRI study. Cognitive Brain Research, 20, 226–241. https://doi.org/10.1016/j.cogbrainres.2004.02.012.
Goodwin, H., Yiend, J., & Hirsch, C. (2017). Generalized Anxiety Disorder, worry and attention to threat: A systematic review. Clinical Psychology Review, 54, 107–122. https://doi.org/10.1016/j.cpr.2017.03.006.
Hales, S. A., Deeprose, C., Goodwin, G. M., & Holmes, E. A. (2011). Cognitions in bipolar affective disorder and unipolar depression: Imagining suicide. Bipolar Disorders, 13, 651–661. https://doi.org/10.1111/j.1399-5618.2011.00954.x.
Heyes, S. B., Lau, J. F., & Holmes, E. A. (2013). Mental imagery, emotion and psychopathology across child and adolescent development. Developmental Cognitive Neuroscience, 5, 119–133. https://doi.org/10.1016/j.dcn.2013.02.004.
Holmes, E. A., Crane, C., Fennell, M. V., & Williams, J. G. (2007). Imagery about suicide in depression—’Flash-forwards’? Journal of Behavior Therapy and Experimental Psychiatry, 38, 423–434. https://doi.org/10.1016/j.jbtep.2007.10.004.
Holmes, E. A., Lang, T. J., & Deeprose, C. (2009a). Mental imagery and emotion in treatment across disorders: Using the example of depression. Cognitive Behaviour Therapy, 38, 21–28. https://doi.org/10.1080/16506070902980729.
Holmes, E. A., Mathews, A., Mackintosh, B., & Dalgleish, T. (2008). The causal effect of mental imagery on emotion assessed using picture-word cues. Emotion, 8, 395–409. https://doi.org/10.1037/1528-3542.8.3.395.
Holmes, E. A., Lang, T. J., & Shah, D. M. (2009b). Developing interpretation bias modification as a ‘cognitive vaccine’ for depressed mood: Imagining positive events makes you feel better than thinking about them verbally. Journal of Abnormal Psychology, 118, 76–88. https://doi.org/10.1037/a0012590.
Holmes, E. A., & Mathews, A. (2005). Mental imagery and emotion: A special relationship? Emotion, 5, 489–497. https://doi.org/10.1037/1528-3542.5.4.489.
Holmes, E. A., & Mathews, A. (2010). Mental imagery in emotion and emotional disorders. Clinical Psychology Review, 30, 349–362. https://doi.org/10.1016/j.cpr.2010.01.001.
Holmes, E. A., Mathews, A., Dalgleish, T., & Mackintosh, B. (2006). Positive interpretation training: Effects of mental imagery versus verbal training on positive mood. Behavior Therapy, 37, 237–247. https://doi.org/10.1016/j.beth.2006.02.002.
Hyman, I. J., & Pentland, J. (1996). The role of mental imagery in the creation of false childhood memories. Journal of Memory and Language, 35, 101–117. https://doi.org/10.1006/jmla.1996.0006.
Johnson, D. P., & Whisman, M. A. (2013). Gender differences in rumination: A meta-analysis. Personality and Individual Differences, 55, 367–374. https://doi.org/10.1016/j.paid.2013.03.019.
Kosslyn, S. M., Ganis, G., & Thompson, W. L. (2001). Neural foundations of imagery. Nature Reviews Neuroscience, 2, 635–642. https://doi.org/10.1038/35090055.
Kosslyn, S. M., Margolis, J. A., Barrett, A. M., Goldknopf, E. J., & Daly, P. F. (1990). Age differences in imagery abilities. Child Development, 61, 995–1010. https://doi.org/10.2307/1130871.
Lang, P. J., Greenwald, M. K., Bradley, M. M., & Hamm, A. O. (1993). Looking at pictures: Affective, facial, visceral, and behavioral reactions. Psychophysiology, 30, 261–273. https://doi.org/10.1111/j.1469-8986.1993.tb03352.x.
Leigh, E., & Hirsch, C. R. (2011). Worry in imagery and verbal form: Effect on residual working memory capacity. Behaviour Research and Therapy, 49, 99–105. https://doi.org/10.1016/j.brat.2010.11.005.
Mathews, A., Ridgeway, V., & Holmes, E. A. (2013). Feels like the real thing: Imagery is both more realistic and emotional than verbal thought. Cognition and Emotion, 27, 217–229. https://doi.org/10.1080/02699931.2012.698252.
McLaughlin, K. A., Borkovec, T. D., & Sibrava, N. J. (2007). The effects of worry and rumination on affect states and cognitive activity. Behavior Therapy, 38, 23–38. https://doi.org/10.1016/j.beth.2006.03.003.
Moritz, S., Hörmann, C. C., Schröder, J., Berger, T., Jacob, G. A., Meyer, B., … Klein, J. P. (2014). Beyond words: Sensory properties of depressive thoughts. Cognition and Emotion, 28, 1047–1056. https://doi.org/10.1080/02699931.2013.868342.
Nelis, S., Holmes, E. A., Palmieri, R., Bellelli, G., & Raes, F. (2015). Thinking back about a positive event: The impact of processing style on positive affect. Frontiers in Psychiatry, 6.
Newby, J. M., & Moulds, M. L. (2012). A comparison of the content, themes, and features of intrusive memories and rumination in major depressive disorder. British Journal of Clinical Psychology, 51, 197–205. https://doi.org/10.1111/j.2044-8260.2011.02020.x.
Newman, M. G., & Llera, S. J. (2011). A novel theory of experiential avoidance in generalized anxiety disorder: A review and synthesis of research supporting a contrast avoidance model of worry. Clinical Psychology Review, 31, 371–382.
Nolen-Hoeksema, S. (1987). Sex differences in unipolar depression: Evidence and theory. Psychological Bulletin, 101, 259–282. https://doi.org/10.1037/0033-2909.101.2.259.
Nolen-Hoeksema, S. (1990). Sex differences in depression. Stanford University Press.
Nolen-Hoeksema, S. (2000). The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. Journal of Abnormal Psychology, 109, 504–511. https://doi.org/10.1037/0021-843X.109.3.504.
Nolen-Hoeksema, S. (2001). Gender differences in depression. Current Directions in Psychological Science, 10, 173–176.
Nolen-Hoeksema, S., & Davis, C. G. (1999). ‘Thanks for sharing that’: Ruminators and their social support networks. Journal of Personality and Social Psychology, 77, 801–814. https://doi.org/10.1037/0022-3514.77.4.801.
Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61, 115–121. https://doi.org/10.1037/0022-3514.61.1.115.
Nolen-Hoeksema, S., Morrow, J., & Fredrickson, B. L. (1993). Response styles and the duration of episodes of depressed mood. Journal of Abnormal Psychology, 102, 20–28.
O’Craven, K. M., & Kanwisher, N. (2000). Mental imagery of faces and places activates corresponding stimulus-specific brain regions. Journal of Cognitive Neuroscience, 12, 1013–1023. https://doi.org/10.1162/08989290051137549.
Patel, T., Brewin, C. R., Wheatley, J., Wells, A., Fisher, P., & Myers, S. (2007). Intrusive images and memories in major depression. Behaviour Research and Therapy, 45, 2573–2580. https://doi.org/10.1016/j.brat.2007.06.004.
Pearson, M., Brewin, C. R., Rhodes, J., & McCarron, G. (2008). Frequency and nature of rumination in chronic depression: A preliminary study. Cognitive Behaviour Therapy, 37, 1–9. https://doi.org/10.1080/16506070801919224.
Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. https://doi.org/10.1177/014662167700100306.
Rapee, R. M. (1993). The utilisation of working memory by worry. Behaviour Research and Therapy, 31, 617–620. https://doi.org/10.1016/0005-7967(93)90114-A.
Richardson, J. E. (1995). Gender differences in the Vividness of Visual Imagery Questionnaire: A meta-analysis. Journal of Mental Imagery, 19, 177–187.
Stöber, J. (2000). Prospective cognitions in anxiety and depression: Replication and methodological extension. Cognition and Emotion, 14, 725–729. https://doi.org/10.1080/02699930050117693.
Szőllősi, Á, Pajkossy, P., & Racsmány, M. (2015). Depressive symptoms are associated with the phenomenal characteristics of imagined positive and negative future events. Applied Cognitive Psychology, 29, 762–767. https://doi.org/10.1002/acp.3144.
Thomas, J., Raynor, M., & Ribott, D. (2015). Depressive rumination and experiential avoidance: A task based exploration. Personality and Mental Health, 9, 58–65. https://doi.org/10.1002/pmh.1276.
Watkins, E., Moulds, M., & Mackintosh, B. (2005). Comparisons between rumination and worry in a non-clinical population. Behaviour Research and Therapy, 43, 1577–1585. https://doi.org/10.1016/j.brat.2004.11.008.
Weissman, M. M., & Klerman, G. L. (1977). Sex differences and the epidemiology of depression. Archives of General Psychiatry, 34, 98–111.
Werner-Seidler, A., & Moulds, M. L. (2012). Mood repair and processing mode in depression. Emotion, 12, 470–478. https://doi.org/10.1037/a0025984.
Williams, A. D., & Moulds, M. L. (2007). An investigation of the cognitive and experiential features of intrusive memories in depression. Memory, 15, 912–920. https://doi.org/10.1080/09658210701508369.
Funding
During the preparation of this manuscript, the first author was supported by the University of Maine Janet Waldron Doctoral Research Fellowship.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Hannah R. Lawrence, Emily A. P. Haigh, Greg J. Siegle, and Rebecca A. Schwartz-Mette declare that they have no conflict of interest.
Informed Consent
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
Animal Rights
This article does not contain any studies with animals performed by any of the authors.
Rights and permissions
About this article
Cite this article
Lawrence, H.R., Haigh, E.A.P., Siegle, G.J. et al. Visual and Verbal Depressive Cognition: Implications for the Rumination–Depression Relationship. Cogn Ther Res 42, 421–435 (2018). https://doi.org/10.1007/s10608-018-9890-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10608-018-9890-0